Healthcare Provider Details

I. General information

NPI: 1932143567
Provider Name (Legal Business Name): LUIS ALBERTO REIMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FERNANDEZ JUNCOS ST.B-5.EDIFICIO VANESSA
CAROLINA PR
00985
US

IV. Provider business mailing address

119-29 CALLE 67 URB:VILLA CAROLINA
CAROLINA PR
00985-5322
US

V. Phone/Fax

Practice location:
  • Phone: 787-768-4993
  • Fax: 787-768-0040
Mailing address:
  • Phone: 787-701-0850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number15012
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: